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A similar situation is often observed in asthenic, detrained persons, as well as people suffering from diseases associated with weakness of the connective tissue (Marfan's syndrome, flat feet, varicose veins, hemorrhoids, intestinal diverticulosis, etc.). In this regard, paraesophageal hernia often accompanies femoral hernia, inguinal hernia, hernia of the white line of the abdomen, umbilical hernia.
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Factors that increase the risk of developing a hernia are circumstances accompanied by a systematic or sudden critical increase in intra-abdominal pressure. chronic constipation indomitable vomiting flatulence ascites heavy physical labor simultaneous lifting of a heavy load sharp bends blunt abdominal trauma severe obesity severe and prolonged cough in chronic obstructive bronchitis, bronchial asthma and other non-specific lung diseases.
According toBased on the data, about 18% of women with repeated pregnancies suffer from diaphragmatic hernia. Also, the development of a hernia predisposes to buy lamisil online of the motility of the digestive tract with hypermotor dyskinesia of the esophagus, concomitant peptic ulcer of the duodenum and stomach, chronic gastroduodenitis, pancreatitis, calculous cholecystitis.
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The occurrence of hernias is facilitated by the longitudinal shortening of the esophagus due to its cicatricial-inflammatory deformity, which has developed as a result of reflux esophagitis, esophageal peptic ulcer, chemical or thermal burns. A direct consequence of the weakening of the ligamentous apparatus of the diaphragm is the expansion of the esophageal opening and the formation of a hernia gate, through which the abdominal portion of the esophagus and the cardial part of the stomach prolapse into the chest cavity.
The abdominal part of the esophagus is located above the diaphragm, the cardia is located at the level of the diaphragm, and the stomach is directly adjacent to buy terbinafine pills. II degree. There is a displacement of the abdominal esophagus into the chest cavity and the location of the stomach in the region of the esophageal opening of the diaphragm. III degree. In the chest cavity there are all subdiaphragmatic structures - the abdominal part of the esophagus, cardia, fundus and body of the stomach (sometimes the antrum of the stomach).
Modern abdominal surgeons and gastroenterologists distinguish three degrees of hernial protrusion based on radiological signs and volume of displacement of the stomach into the chest cavity. In accordance with the anatomical features, sliding, paraesophageal and mixed diaphragmatic hernias are distinguished. With a sliding (axial, axial) hernia, there is free penetration of the abdominal part of the esophagus, cardia and fundus of lamisil pills through the esophageal opening of the diaphragm into the chest cavity and an independent return (when changing body position) back to the abdominal cavity. Axial hernias occur in most cases and, depending on the displaced area, can be cardiac, cardiofundal, subtotal or total gastric.
About half of the cases are asymptomatic or are accompanied by mild clinical manifestations. A typical sign of pathology is pain syndrome, which is usually localized in the epigastrium, spreads along the esophagus or radiates to the interscapular region and back. Sometimes the pain can be girdle in nature, resembling pancreatitis.